Soluble vascular endothelial growth factor receptor-2 and inflammatory factors in macular edema with branch retinal vein occlusion

Am J Ophthalmol. 2011 Oct;152(4):669-677.e1. doi: 10.1016/j.ajo.2011.04.006. Epub 2011 Jul 2.

Abstract

Purpose: To investigate relationships among vitreous fluid levels of soluble vascular endothelial growth factor receptor-2 (sVEGFR-2), vascular endothelial growth factor (VEGF), and soluble intercellular adhesion molecule 1 (sICAM-1) in patients with branch retinal vein occlusion (BRVO) and macular edema or patients with idiopathic macular hole.

Design: Retrospective case-control study.

Setting: Tokyo Women's Medical University and Eguchi Eye Hospital.

Patient population: Forty-nine Japanese patients who underwent unilateral vitrectomy (27 with BRVO and 22 with macular hole).

Observation procedures: Vitreous fluid samples were obtained during vitreoretinal surgery to measure the levels of sVEGFR-2, VEGF, and sICAM-1. Retinal ischemia was evaluated from capillary nonperfusion on fluorescein angiography. Macular edema was examined by optical coherence tomography.

Main outcome measures: Vitreous fluid levels of the 3 molecules and severity of macular edema.

Results: BRVO patients had a significantly higher vitreous fluid level of sVEGFR-2 (median, 1670 pg/mL; interquartile range [IQL], 1205 to 2225 pg/mL) than macular hole patients (median, 1265 pg/mL; IQR, 731 to 1800 pg/mL; P = .017), as was the case for VEGF (median, 237 pg/mL; IQR, 42.2 to 1305 pg/mL; vs median, 15.6 pg/mL; IQR, 15.6 to 15.6 pg/mL; P < .001) and sICAM-1 (median, 10.1 ng/mL; IQR, 6.3 to 22.5 ng/mL; vs median, 4.1 ng/mL; IQR, 3.3 to 6.0 ng/mL; P < .001). In BRVO patients, there was a significant positive correlation between vitreous fluid levels of sVEGFR-2 or VEGF and sICAM-1, but not between sVEGFR-2 and VEGF. Vitreous fluid levels of all 3 molecules were correlated significantly the with severity of macular edema in BRVO patients.

Conclusions: sVEGFR-2 may induce an increase of vascular permeability together with or via sICAM-1, or both with and via sICAM-1, in BRVO patients with macular edema.

MeSH terms

  • Aged
  • Case-Control Studies
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Fluorescein Angiography
  • Humans
  • Intercellular Adhesion Molecule-1 / metabolism*
  • Laser Coagulation
  • Macular Edema / diagnosis
  • Macular Edema / metabolism*
  • Macular Edema / surgery
  • Male
  • Retinal Perforations / metabolism
  • Retinal Vein Occlusion / diagnosis
  • Retinal Vein Occlusion / metabolism*
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Vascular Endothelial Growth Factor A / metabolism*
  • Vascular Endothelial Growth Factor Receptor-2 / metabolism*
  • Vitrectomy
  • Vitreous Body / metabolism*

Substances

  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Intercellular Adhesion Molecule-1
  • Vascular Endothelial Growth Factor Receptor-2